RU2114601C1 - Method of parodontium sickness treatment - Google Patents

Abstract

FIELD: medicine, surgery stomatology. SUBSTANCE: method involves administration of drug - bioglass ceramic-base paste into parodontal pocket to recovery alveolar branch osseous tissue and for stabilization of pathological process in parodontium. Paste has the following composition, wt.-%: sodium alginate 15.0-18.0; magnesium sulfate 16.0-20.0; calcium hydrophosphate 38.0-43.0; calcium chloride 0.7-1.0; microgranulated bioglass M-31 (particle size is 100-300 mcm) 20.0-27.0 and mixed with 1% an aqueous solution of dioxydine. Method ensures to accelerate stabilization of pathological process in parodontium up to 4 months. EFFECT: enhanced effectiveness of method.

Description

 The invention relates to medicine, specifically to therapeutic and surgical dentistry and can be widely used in the practice of treating periodontal diseases by surgical techniques.

 Periodontal disease is one of the most difficult problems in dentistry. According to WHO (1990), based on a survey of 53 countries, the level of periodontal disease is between 15-19 years old - 99%, in 35-44 - 98%. On this basis, when solving the problems of complex treatment of periodontal diseases, along with conservative methods, surgical interventions using transplant and implant materials are especially relevant.

 As transplants, the serous membrane of the small intestine (USSR patent N 1128917, 1985), allograft (USSR patent N 1125530, 1986), formalized decalcified bref or allograft (USSR patent N 1572536, 1990) are used. But they have the following disadvantages: antigenic activity, weak anti-inflammatory effect, difficulty in preparation and storage.

 It is known to use biodegradable composite materials for internal use - implants: (US Patent N 5108755, 1993).

 Biodegradable composite materials for internal use. Biodegradable composite materials - reinforced fibers - polymers (polylactic, polyglycolic, etc. and their mixtures). As fiber - calcium phosphate, polyglycolic acid, polyphosphate of calcium, sodium, aluminum. Used as a bone substitute.

 Disadvantages: to obtain fibers requires special equipment, a complex manufacturing process; the impossibility of using fiber according to the claimed method of treatment, the difficulty of introducing into a narrow periodontal pocket.

 UK patent N 2169914, 1987.

 Implantable material for replacing hard tissues in a living organism.

 10-90% calcium phosphate with inorganic glass fibers and 10-90% biocompatible organic high polymer material. In the implant, part of the glass fibers is exposed, on its surface there is a polymer component, which can be polyglycolic, polyacetic acid, polymethyl methacrylate, etc.

Disadvantages: to obtain fibers requires special equipment, a complex manufacturing process;
the impossibility of using fiber according to the claimed method of treatment, the difficulty of introducing into a narrow periodontal pocket.

 The use of bio-metals in dentistry is known (Japan Patent N 57-40803).

 A method for producing jaw prostheses and dentures based on apatide sintering products.

MgO-N ₂ O, K ₂ O, CaF ₂ , Al ₂ O ₃ , SiO ₂ - 50-99%
Ca ₅ (PO ₄ ) ₃ OH + - 1-50% Ca ₃ (PO ₄ ) ₂ particle size distribution 20-300 μm Sintering 500-1700 ^o C - 10 - 600 min.

 Disadvantages: rigid structure, manufacturing in advance, to replace relatively large bone defects of the jaw.

 All of the above methods, selected as analogues, cannot solve the problem of restoring lost bone tissue of the alveolar process, stabilizing the pathological process in periodontal tissues and cannot be used instead of the treatment method we are proposing.

 The closest in technical essence and scope adopted for the prototype is the "Method of surgical treatment of periodontitis" by A.P. Bezrukov, P.P. Istranov, V.D. Razvadovsky and others (ed. Certificate of the USSR N 1568979, 1986 ), according to which the method of treatment of periodontal diseases consists in surgical intervention with the introduction of a 0.4-0.6% aqueous collagen solution together with a 0.1-0.3% glutaraldehyde solution into the narrow periodontal pockets using a syringe.

 Despite the fact that this method of surgical treatment of periodontitis has a good anti-inflammatory effect and is easily inserted into narrow periodontal pockets, it has significant disadvantages.

The disadvantages of the method: a narrow scope - only periodontal pockets with 2-3 walls; in the wide single-wall pockets, which are more common, the mixture from the syringe will spill;
collagen does not have sufficient immune inertness;
in the proposed composition there is no osteogenic component that stimulates bone restoration;
Thus, the method of treatment according to the prototype does not lead to the restoration of bone tissue of the alveolar process.

 The present invention compared with the prototype has significant distinguishing features, one hundred allows us to consider the claimed method of treatment that meets the criterion of "novelty."

 The aim of the present invention is the restoration of lost bone tissue of the alveolar process, stabilization of the pathological process in periodontal tissues.

 This goal is achieved by the fact that in the periodontal pocket during surgery, a paste based on bio-metal is introduced, consisting, by weight. %: 15.0-18.0 sodium alginate; 16.0 - 20.0 magnesium sulfate; 38.0 - 43.0 calcium hydrogen phosphate; 0.7 - 1.0 calcium chloride; 20.0 - 27.0 microgranular 100 - 300 microns of biosetall M-31, and mixed in a 1% aqueous solution of dioxidine.

A method of manufacturing a paste based on bio-metal. (on the example of cooking 100 g of paste)
Take all the necessary components (see table. 1); weigh 16.4 g of sodium alginate, 16.4 g of magnesium sulfate, 41.0 g of calcium hydrogen phosphate, 0.8 g of calcium chloride (technical pharmacy balance type BP-100).

 Place weighed quantities of substances in a mortar (porcelain or agate pharmacy mortars with a pestle) and mix until uniform.

 Weigh 25.4 g of micro-granulated M-31 bio-glass.

 Put in a mortar with a mixture of powders of bio-metal M-31 and mix thoroughly with a spatula.

 Place the mixture in a sterile glass dish, sterilize (gamma rays 1.5 Mrad), clog and mark the paste with bio-metal based paste.

 Store at room temperature and normal humidity.

 In the dental office or in the operating room during surgery for periodontal disease, it is necessary to take a small amount of powder and knead on a glass slide, adding a 1% aqueous solution of dioxidine, until a homogeneous pasty-like consistency is obtained, giving a shape that is convenient for work. After 10 minutes, the paste is structured and ready for insertion into the periodontal pocket.

 The compositions of the paste based on biositall according to the claimed method of treatment are given in table. one.

 Foreign compositions 4, 5 do not allow to obtain a homogeneous, pasty, non-sticky paste.

 All salt components should be in terms of quality reagents of grades of industrial production "hch", "chda", or pharmaceutical preparations marked "for internal use".

 Sodium alginate is a sodium salt of alginic acid. Obtained from brown algae, used as a gelling agent and emulsifier. In medical practice, wound healing, antibacterial, hemostatic properties are used.

MgSO ₄ - magnesium sulfate - magnesium sulfate, a bitter salt, is widely used in medical practice in the form of a powder (MgSO ₄ • 7H ₂ O) and aqueous solutions. In the paste acts as a hardening regulator.

CaHPO ₄ - calcium hydrogen phosphate is a natural mineral or a compound obtained by synthesis of phosphorus and calcium. Used as a component of toothpastes and powders, a mineral supplement to vitamins. Compounds of calcium, phosphorus, magnesium are necessary for the formation of bone tissue.

CaCl ₂ - calcium chloride; widely used in medicine, hygroscopic, so that the paste becomes not "sticky" and does not stick to the tool.

Biosital - M-31, a glass-crystalline substance in the SiO ₂ - MgO-ZnO-CaO system, is approved for clinical trials in the "Dentistry" section, Protocol N5 dated 06.29.95. Committee on Science and Technology.

The biositall formulation - M-31, wt.%
SiO ₂ - 37 - 39.3
P ₂ O ₅ - 13 - 15.5
Al ₂ O ₃ - 6.3 - 9.6
CaO - 34.5 - 35.2
MgO - 3.08 - 2.95
ZnO - 3.8 - 4.95
Biosital - M-31 was developed at SPbGTI within the framework of the national program of the State Polytechnical Institute of Russia “New Materials” (project 007.05.010M) of the Ministry of Science and Technology of the Russian Federation.

 Biosital - M-31 is used in the form of microgranules with particle sizes of 100 - 300 microns. When the particle size is <100 μm, the large specific surface of the particles has a high water absorption capacity (hydrophilicity), which prevents the uniform mixing of the powdery components of the paste in aqueous solutions. With particle sizes above 300 microns, the bio-metal particles are chipped from the paste and the narrow pocket is injured (scratched) when the paste is introduced.

 Properties of paste based on bio-metal.

 To determine the most important primary characteristics of the behavior of the paste of compositions 1, 2, 3 (see Table 1) in biological media, samples were made (manually formed) in the form of balls of various diameters, tablets, whetstones, cylinders. The weight of each sample was 0.10 - 0.15 g. For each experiment, a batch of 10 pieces was taken.

As model media that mimic the effects of body fluids on material, for testing we used: distilled water and Ringer-Locke solution (physiological composition for warm-blooded):
NaCl - 0.60 g
KCl - 0.02 g
CaCl ₂ - 0.02 g
NaHCO ₃ - 0.01 g
Glucose - 0.10 g
H ₂ O d. - up to 100 ml
The tests were carried out at room temperature and at +37 ^o C.

 The exposure time of the samples in solutions ranged from 1 day to 100 days.

 The tests were carried out in different modes of exposure of the liquid medium to the samples: in static mode; on the duct; drip-air irrigation of samples.

 In all cases of the experiment, the samples were weighed before starting work and measurements of their geometric dimensions were carried out, i.e. The initial values of the mass and volume of the samples were determined. Determination of changes in mass and volume was carried out discretely in the experiment: after 1 day, 3 days, 7 days, ..... individual lots up to 100 days of exposure to media.

Experiment Results:
the pH of the aqueous medium after testing the samples remained neutral, in the range of 7.3 - 7.4 units;
the samples did not change the consistency; they retained the viscoelastic properties of the gel;
changes in the mass of paste samples in different modes of exposure to the liquid reagent are presented in table 2.

 The value of the prognostic characteristic - bioresistance of 0.007 - 0.011 mg / g per day.

 From the literature, pastes of the indicated composition for the treatment of periodontal diseases are unknown. The proposed paste based on bio-metal meets the requirements of medical implantation technology: doughy consistency; does not crumble and does not stick to the spatula; structured after the introduction of a liquid former in air for 10 min; retains its shape in a liquid medium (volume change in a free state does not exceed 15%); the aqueous solution of the paste has a pH close to the pH of physiological saline; does not contain carcinogenic, allergenic substances, contains osteocompatible, osteoinductive bio-metal M-31 in the form of porous microgranules.

 The use of the proposed method for the treatment of periodontal diseases with the introduction into the periodontal pocket of a paste based on bio-metal, having an original composition that helps to restore the bone tissue of the alveolar ridge, stabilization of the pathological process in the periodontium, which suggests that the technical solution meets the criterion of "significant differences".

 This treatment was tested on 85 animals - Wistar rats. After experimentally induced chronic generalized periodontitis of a developing stage of moderate severity, rats underwent surgical interventions with the introduction of a mixture of 1, 2, 3 on 45 animals in the periodontal pockets of the paste and without the introduction of a bio-ceramic paste on 25 animals. 10 rats were not treated. On the lateral teeth of rats under general anesthesia, a gingivotomy was performed with a protective bandage made of repin, and on the central incisors, a patchwork operation with suturing from polyamide was performed.

 Clinical observations, radiological images, morphological studies show the advantages of this method of treatment of periodontal diseases, if possible, to stabilize the pathological process in periodontal disease and restore bone tissue of the alveolar process.

 This method of treatment of periodontal disease was used in 25 patients with their consent.

The positive effect of using paste based on biositall is evaluated according to the following clinical signs in terms of 5 - 7, 21 days, 1.5 - 2, 4, 12 months after surgery and was compared with preoperative indices:
bleeding index (IR);
papillary-marginal-alveolar index (PMA);
periodontal index (PI).

 X-ray studies were performed before the operation, 1.5-2, 4, 12 months after the operation.

 This method of treating periodontal disease is illustrated by the following clinical examples.

 Example 1. Patient B., 46 years old, complained to the City Periodontic Center of bleeding during brushing, sensitivity from all teeth cold, tooth mobility, impaired diction. Considers herself a patient for 3 years, previously treated conservatively at the place of residence, but no positive effect was observed. History of iron deficiency anemia, xp. erosive gastritis, hr. cholecystitis, diffuse non-toxic goiter.

 Inspection of the oral cavity: the gum is slightly hyperemic throughout, abundant supra- and subgingival deposits, generalized gum retraction by 2-4 mm, periodontal pockets 8-4 / 4-8 on the military unit with a depth of 6 mm and mobility of the III degree; at n / h 875/458 periodontal pockets 5 mm, mobility 8/8 - III degree, 75/45 - II degree. The bleeding index is I, PMA = 60%, PI = 6.0. In intraoral x-rays, uneven resorption of bone tissue in the 87/8 area per hour and 87/8 per hour / 2/3 of the root length, complete resorption of the interdental septum, tooth displacement, impaired diction.

 At 54/4567 at the military unit and 54/45 at the unit / hour bone resorption at 1/2 root length.

 Diagnosis: chronic generalized periodontitis of a developed stage of a severe degree.

Treatment plan: 1) training in oral hygiene skills;
2) removal of dental plaque followed by polishing of the necks of the teeth;
3) local anti-inflammatory therapy;
4) general treatment taking into account the anamnesis;
5) a patchwork operation in sectors with the introduction of paste based on bio-metal;
6) rational prosthetics.

 Under conduction and infiltration anesthesia Sol. Lidocaini 2% - 10.0 ml + Sol.Adrenalini 0.01% -1gtts. a horizontal incision was made along the vertices of the interdental papillae in the region of 8754321/12345 on the lower jaw. The mucosal-periosteal flap is exfoliated, granulations are scraped out, subgingival dental deposits are removed. The operating nurse uses a sterile spatula to take a gamma-sterilized powder of composition 1 from a glass bottle. %: sodium alginate - 15.0; magnesium sulfate 16.0; calcium hydrogen phosphate 43.0; calcium chloride 0.9; Biosital M-31 25.1. Mixes it on a glass slide with a 1% aqueous solution of dioxidine until a homogeneous, pasty-like consistency is obtained. After 10 minutes, the paste is ready for use. The epithelization of the flap. The operating doctor conducts homeostasis and inserts a paste based on biosetall into tight contact with bone tissue with a trowel in periodontal pockets. Suture with polyamide thread. The patient is given recommendations for postoperative care.

 After 3 weeks, a patch operation on the teeth of the military unit was performed.

 In this case, the cattle is impossible to use the method of treatment of periodontitis, which we have chosen for the prototype due to the presence of mainly wide periodontal pockets.

 Postoperative edema was absent. On the 3rd day of observation, the gum is not hyperemic; IR = 0, PMA = 0.6, PI = 0.1.

 Removal of sutures on the 6th day, the gum is pale pink, tightly covers the neck of the tooth, IR = 0, PMA = 0.1, PI = 0.

 After 3 weeks, the gingival pocket was eliminated, the architectonics of the gingival papillae were restored, IR = 0, PMA = 0, PI = 0.

 After 2 months, the follow-up observation showed no signs of gingival inflammation, there are no signs of an active inflammatory process on x-rays, after 4 months there is no clinically no pathological process in the periodontium, pathological tooth mobility, restoration of the chewing function of the teeth, normalization of diction. On the x-ray images there are no foci of osteoporosis, the bone tissue is compacted, its progressive loss is not observed. Bone tissue restoration in the region of 54/4567 v / h and 54/45 n / h to 1/3 of the root length, and teeth 87/8 v / h and 87/8 n / h to 1/2 of the root length. After 12 months, the stabilization of the clinical and radiological picture is preserved.

 Example 2: Patient T, 38 years old, complained to the GPC of bleeding during brushing, tooth mobility, and diction disturbance. Previously, periodontal disease has not been treated. A history of urolithiasis.

 Examination of the oral cavity: the gum is hyperemic, swollen throughout the gingival margin, supra- and subgingival deposits, generalized gum retraction, periodontal pockets in the 321/1237 area for n / h and 73/5 for v / h more than 6 mm, tooth mobility III degrees, in the field of 5421/123467 at the military unit and 654/456 at the unit of vehicle 4-5 mm, mobility of the II degree. Poor oral hygiene, a bleeding index of 1, PI = 7.3, PMA = 69%.

 On intraoral radiographs of bone tissue more than 2/3 in the region 321/1237 at n / h and 73/5 at / h, in the remaining areas there is uneven resorption up to 1/2 of the root length.

 Diagnosis: chronic generalized periodontitis of a developed stage of a severe degree.

Recommended: training in oral hygiene skills;
general treatment (ibuprofen, tavegil, multivitamins with trace elements);
local anti-inflammatory therapy;
selective grinding of teeth followed by temporary splinting 321/123 per n / h;
patchwork operation with the introduction of paste based on bio-metal.

 The patchwork operation was carried out in 2 stages: 1) 754321 / on the right for n / h and 7654321 / on the / h, 2) / 1234567 on n / h and / 1234567 on / h on the left.

 At n / h 321/123 temporary bus.

 Under the conduction and infiltration anesthesia Sol.Ultracaini 2% -10, Oml, a horizontal bordering incision was made along the tops of the interdental papillae in the region of 754321 / n / h and 7654321 / on / h on the right. The mucosal-periosteal flap is exfoliated, granulations are scraped out, subgingival dental deposits are removed. The operating nurse with a sterile spatula takes a gamma-sterilized powder from a glass bottle with a composition of wt.%: Sodium alginate 16.0; magnesium sulfate 18.0; calcium hydrogen phosphate 38.0; calcium chloride 1.0; Biosital M-31 27.0. Mixes it on a glass slide with a 1% aqueous solution of dioxidine until a homogeneous, pasty-like consistency is obtained. After 10 minutes, the paste is ready for use. The operating doctor performs de-epithelialization of the flap, treats the wound surface with a 3% hydrogen peroxide solution, and dries. After that, the trowel introduces a paste based on bio-glass into the periodontal pockets into direct contact with the bone. Sutures are applied with polyamide thread, a repin protective dressing. The patient is given postoperative recommendations.

 In this case, it was impossible to use the method of treatment of periodontitis, selected for the prototype due to the presence of mainly wide periodontal pockets.

 After 3 weeks, a similar patchwork was performed on the left in the area of 1234567 / at n / h and 1234567 / at / h with the introduction of bio-metal paste to the periodontal pockets.

 Postoperative pain and swelling were absent. On the 3rd day, the gum is not hyperemic, IR = 0, PMA = 0.6, PI = 0.1. Removal of sutures on the 6th day, the gum is pale pink, tightly adjacent to the neck of the tooth, IR = 0, PMA = 0.1, PI = 0. After 3 weeks, the gingival pockets were eliminated, IR = 0, PMA = 0, PI = 0.

 After 2 months, the follow-up observation showed no signs of gingival inflammation, there are no signs of an active inflammatory process on x-rays, after 4 months, the pathological process in the periodontium is clinically stabilized, the tooth has no pathological mobility, the chewing function of the teeth is restored, and diction is normalized. There are no foci of osteoporosis on the x-ray photographs, bone tissue is compacted, its progressive decrease is not observed, bone tissue restoration in the 321/1237 section at n / h and 73/5 at / h to 1/2 root length, in the remaining sections to 1 / 3 lengths of roots.

 After 12 months, the stabilization of the X-ray and clinical picture remains.

 Example 3. Patient H., 32 years old, complained to the GPC of swelling, suppuration, pain in the region of 2 teeth on the right of the military unit.

 History of frequent rhinitis. Regarding periodontal disease has not previously been treated. 2 years ago there was an injury in the area of this tooth, after which inflammation developed, which was poorly stopped conservatively by the patient herself.

 Examination of the oral cavity: the gum in the area of 2 teeth on the right of the military unit is hyperemic, edematous. There is suppuration from a periodontal pocket, a periodontal pocket of 5 mm. Tortoanomaly of the tooth. In the remaining areas, periodontal pockets are absent, the gums are dense, pale pink. Hygiene index unsatisfactory, PMA = 9, PI = 1.0. In the intraoral image in area 2 / resorption of 1/2 root length.

 Diagnosis: moderate chronic localized periodontitis.

Treatment plan: local anti-inflammatory therapy;
selective grinding in area 2 /;
curettage of periodontal pocket 2 /;
temporary splinting 321 /.

 Curettage was performed under local anesthesia Sil.Ultracaini 2% -2, Oml. The operation begins with the removal of subgingival dental deposits, polish the surface of the root. The operating nurse with a sterile spatula takes a gamma-sterilized powder from a glass bottle with a composition of 3 wt.%: Sodium alginate 18.0; magnesium sulfate 19.3; calcium hydrogen phosphate 42.0; calcium chloride 0.7; Biosital M-31 - 20.0. It mixes it on a glass slide with a 1% aqueous solution of dioxide until a homogeneous, pasty-like consistency is obtained. After 10 minutes, the paste is ready for use. The operating doctor proceeds to treat the inner surface of the gingival wall of the pathological gingival pocket, removes granulation and ingrown epithelium. Then the wound surface is treated with a 3% solution of hydrogen peroxide, dried and the paste is inserted into the periodontal pockets of the bio-metal paste in direct contact with the bone. A gum wall of the periodontal pocket is pressed against the tooth with a sterile swab, a protective bandage made of repin. The patient is given postoperative recommendations.

 Postoperative pain and swelling were absent. On the 3rd day, the gum is not hyperemic, IR = 0, PMA = 0.2, PI = 0.1.

 Removing the protective dressing on the 6th day, the gum is pale pink, tightly adjacent to the neck of the tooth, IR = 0, PMA = 0.1, PI = 0. After 3 weeks, the gingival pocket was eliminated, IR = 0, PMA = 0, PI = 0.

 After 1.5 months, the follow-up observation showed no signs of gingival inflammation, there are no signs of an active inflammatory process on the x-ray, after 4 months there is no clinically no pathological process in the periodontium, pathological tooth mobility 2 / h / h restoration of the chewing function of the tooth, normalization of the tooth position. On the x-ray image there are no foci of osteoporosis, bone tissue is compacted, its progressive decrease is not observed, bone tissue recovery in the area 2 / h / h to 1/3 of the root length.

 After 12 months, the stabilization of the X-ray and clinical picture remains.

 Example 4: Patient P., 22 years old, turned to the GPC on 03/05/95 with complaints of pain, suppuration in the region of 6 / tooth n / h.

 He is almost healthy in history, has not previously been treated for periodontal disease.

 Examination of the oral cavity: the gum is pale pink, dense. But in the area 6 / tooth n / h there is a fistulous course with suppuration located in the attached gum. An overhanging amalgam filling is placed on the tooth chewing and distally, the interdental papilla is hyperemic, swollen, and bleeds easily when probed. Periodontal pocket 5 mm. On the roentgenogram in the area of 6 / tooth n / h, bone tissue decreases by 1/2 of the root length.

 Diagnosis: exacerbation of chronic localized periodontitis of a developed stage of moderate degree.

 Treatment plan: replacement of the seal; local anti-inflammatory therapy; gingivotomy in the area of 6 / tooth n / h.

 Under torus anesthesia Sol.Ultracaini 2% -2.0 ml produce a vertical incision of the gums parallel to the axis of the tooth to the entire depth of the periodontal pocket, starting from the bottom to the gingival margin. The operating nurse with a sterile spatula takes a gamma-sterilized powder from a glass bottle with a composition of 3 wt.%: Sodium alginate 18.0; magnesium sulfate 19.3; calcium hydrogen phosphate 42.0; calcium chloride 0.7; Biosital M-31 20.0. Mixes it on a glass slide with a 1% aqueous solution of dioxidine until a homogeneous, pasty-like consistency is obtained. After 10 minutes, the paste is ready for use. The operating physician proceeds to remove granulation and ingrown epithelium from the inner surface of the gums. Then the wound surface is treated with a 3% solution of hydrogen peroxide, dried and the paste is inserted into the periodontal pockets of the bio-metal paste in direct contact with the bone. With a sterile swab, the gingival wall of the periodontal pocket is pressed against the tooth, and the sutures are made of polyamide. The patient is given postoperative recommendations.

 Postoperative pain and swelling were absent. On the 3rd day, the gum is not hyperemic, IR = 0, PMA = 0.1, PI = 0.1.

 Removal of sutures on the 6th day, the gum is pale pink, tightly adjacent to the neck of the tooth, IR = 0, PMA = 0.1, PI = 0. After 3 weeks, the gingival pocket was eliminated, IR = 0, PMA = 0, PI = 0.

 After 1.5 months, the follow-up observation showed no signs of gingival inflammation, there are no signs of an active inflammatory process on the x-ray, after 4 months, the pathological process in the periodontium is clinically stabilized, and the mastication function of 6 / tooth n / h is restored. On the x-ray there are no foci of osteoporosis, bone tissue is compacted, its progressive loss is not observed, bone tissue restoration in the area 6 / tooth n / h to 1/3 of the root length.

 After 12 months, the stabilization of the X-ray and clinical picture remains.

 The treatment method was used in surgical interventions in 25 patients with periodontal diseases with their consent.

 On the 5-7th day after the removal of the sutures, the gum is pale pink, tightly covers the neck of the tooth. After 3 weeks, the gingival pockets were eliminated. After 1.5-2 months, radiographs show no signs of an active inflammatory process: there are no foci of osteoporosis, bone tissue is densified, its progressive decrease is not observed. After 4 months - the absence, stabilization of the pathological process in the periodontium, restoration of the chewing function of the teeth, normalization of diction, aesthetics of the dentition.

Thus, the use of the proposed method for the treatment of periodontal diseases by surgical intervention with the introduction of a paste based on biositall into the periodontal pocket allows you to:
reduce treatment time to 4 months;
to simplify and make the technique convenient (multiple introduction, additional tools are not required);
to ensure, in the absence of toxicity and irritant effect, conditions under which the healing process of the mucoperiosteal flap is accelerated; bone tissue metabolism normalizes;
use pre-prepared material (paste), easy to manufacture; preserving its properties for a long time, not requiring special storage conditions;
quickly stop bleeding of the wound surface due to good obstruction of the entire periodontal pocket and the sodium alginate included in the paste;
does not contain corticosteroids, antibiotics and other potent drugs, therefore it does not have allergenic and carcinogenic properties;
use for both adults and children (there are no contraindications for age groups, for general diseases).

Claims (1)

 A method of treating periodontal diseases by surgical intervention and the subsequent administration of drugs into periodontal pockets, characterized in that, in order to restore the bone tissue of the alveolar process and stabilize the pathological process in the periodontium, a bio-metal paste is introduced into the periodontal pocket, containing, wt.%: 15.0 - 18.0 sodium alginate, 16.0 - 20.0 magnesium sulfate, 38.0 - 43.0 calcium hydrogen phosphate, 0.7 - 1.0 calcium chloride, 20.0 - 27.0 microgranular 100 - 300 microns of M-31 biositall mixed with 1% in one solution of dioxidine.

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